Removal of Phosphorus by Hemodialysis.

Abstract:

:The control of serum phosphorus by dialysis is made difficult by the fact that intradialytic blood levels tend to be low, and because phosphorus is removed almost exclusively from the plasma during its passage through the dialyzer. The most practical way to increase phosphorus removal is to extend dialysis time, although attention to dialysis efficiency (surface area, advanced membrane, and higher blood and dialysate flow rates) also plays a role. Benefits of hemodiafiltration in helping control serum phosphorus have been claimed, but not found in all studies. Because serum phosphorus levels tend to plateau during the later parts of a dialysis session, extending weekly dialysis time is of greater benefit for phosphorus removal than for urea removal. Increasing dialysis frequency also probably has a small benefit. It appears that 18-30 hours of dialysis per week are required to obviate the need for phosphorus binders. Several promising models of phosphorus kinetics are under development. These may help predict the change in treatment on serum phosphorus levels, but their ability to do so has not yet been critically assessed.

journal_name

Semin Dial

journal_title

Seminars in dialysis

authors

Daugirdas JT

doi

10.1111/sdi.12439

subject

Has Abstract

pub_date

2015-11-01 00:00:00

pages

620-3

issue

6

eissn

0894-0959

issn

1525-139X

journal_volume

28

pub_type

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